NC DHHS Secretary proposing BIG Changes for people with mental illness who are insured by Medicaid

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State Representative Verla Insko

Good afternoon MH advocates,

DHHS is sponsoring a series of listening sessions across the state to get input for a strategic plan re: MHDDSA services the Secretary will roll out in early 2018. The announcement appears below. As you are able, please pass the attachment on to people who should know about and attend these meetings. I’m especially interested in getting system users and/or family members to attend.

The issues suggested for discussion in the attachment really do not get at the big changes the Secretary is proposing for the MHDDSA public system. Her top priority is integrated care; her second priority seems to be competition.

To accomplish this, she is proposing to integrate 50 – 60% of the Medicaid MH/SA population into the traditional heath care system and leave the chronic and SPMI MH/SA and all the DD population with three regional LME/MCOs (or non-profit special needs plans) that would integrate primary care and contract for other needed specialty services. These LME/MCOs would also be responsible for the uninsured MHDDSA population. The RFPs for all these plans would go out sometime early next year and be submitted by late Spring or early Summer. The awards would be made later in the year and the plans roll out in 2020 or 2021?

Additional topics for discussion:

What part of the Medicaid covered MHDDSA population can be moved into a traditional health care provider network?

For MH and SA, assume four groups: mild, moderate, chronic and severe and persistent (SPMI).

For DD, assume two groups: moderate and severe

Should we keep the existing 7 LME/MCOs, allow them to continue to build crisis and other community services or consolidate to 3 (or 4) next year and realign them with the traditional health care MCOs?

If consolidate to 3 (or 4), should the Secretary’s office do this in collaboration with other stakeholders or should the LME/MCOs be allowed to arrange their own mergers?

Should the system for the more severely affected (MH/SA chronic and SPMI and all the DD services) continue as a public system with DHHS oversight (LME/MCOs) or should they be spun off as non-profit organizations as special needs plans? (NOTE: the state will have no information about the fund balances of any private sector agency)